Background: Calcium phosphate bone cement increases the stability of implant-bone constructs in patients with an osteoporotic fracture. The purpose of this randomized study was to determine whether augmentation of volar locking plate fixation with calcium phosphate bone cement has any benefit over volar locking plate fixation alone in patients older than sixty-five years of age who have an unstable distal radial fracture.
Methods: Forty-eight patients (fifty unstable distal radial fractures) were recruited for this study. The mean patient age was seventy-three years. Surgical procedures were randomized between volar locking plate fixation alone (Group 1) and volar locking plate fixation with injection of calcium phosphate bone cement (Group 2). The patients were assessed clinically at three and twelve months postoperatively. Clinical assessments included determinations of grip strength, wrist motion, wrist pain, modified Mayo wrist scores, and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiographic evaluations were performed immediately postoperatively and at one year following surgery. The adequacy of the reduction was assessed by measuring radial inclination, volar angulation, and ulnar variance.
Results: The two groups were comparable with regard to age, sex, fracture type, injury mechanism, and bone mineral density. No significant differences were observed between the groups with regard to the clinical outcomes at the three or twelve-month follow-up examination. No significant intergroup differences in radiographic outcomes were observed immediately after surgery or at the one-year follow-up visit. Furthermore, no complication-related differences were observed, and there were no nonunions.
Conclusions: Augmentation of metaphyseal defects with calcium phosphate bone cement after volar locking plate fixation offered no benefit over volar locking plate fixation alone in elderly patients with an unstable distal radial fracture.
Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
Investigation performed at the Department of Orthopedic Surgery, School of Medicine, Ewha Womans University, Seoul, South Korea
Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants of less than $10,000 from Ewha Womans University. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.
- Copyright © 2011 by The Journal of Bone and Joint Surgery, Incorporated
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